15020137 (5) TCO< <q712�
TEMPORARY CERTIFICATE OF OCCUPAN�X FORM vutd
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERT SALVADOR. P.E.. C.B.O.. BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - buildingacupertino.orc,
APN
BP #:
DATE: 1PROJECT
31602110
15020137
06/18/2015 1VALUATION:
SITE
ADDRESS:6 Infinite Loo
OWNER'S NAME:
PHONE* 408-438-0968
Apple / Paul Boyer
FAX #:
MAILING ADDRESS (if different from site address):
1 Infinite Loog Cu ertino CA
CONTRACTOR:
PHONE #: 650-701-1500
NOVO Construction
FAX #:
CONTACT:
- -
PHONE #: 650-208-1186
Alan Wilc nski
Alan
FAX #:
TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION
BOND TYPE: ❑ SURETY BOND AMOUNT (1% VALUATION CODE
❑ CHECK ❑ CASH BOND 1OFBOND: 5K min -10K max 7Gd 3� -G� /BLDBONDSJ EDITION:��
TCO EXPIRATION $286.00/mo TOTAL FEE: $ [1TEMPOCCJ
FEE: � �
DATE (6 MONTHS MAX): 10/27/2015
USE
TYPE OF FLOOR
CONSTR AREA
OCC
LOAD
LEVEL
COMMENT
-ice-
Fire
--�
3...! S ❑ APPROVED
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Signature:.... .......-:....
Date:.....' ..��
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APPROVED
APPROVED WITH CONDITIONS
Si nature:..........
......... ......................
Other:
-Date:
13 APPROVED
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❑ APPROVED
13 APPROVED WITH CONDITIONS
Si nature :.................................................
...
........ Date:.....................
Fire
--�
3...! S ❑ APPROVED
APPROVED WITH CONDITIONS
Signature:.... .......-:....
Date:.....' ..��
u is o s
APPROVED
APPROVED WITH CONDITIONS
Si nature:..........
......... ......................
Other:
-Date:
13 APPROVED
APPROVED WITH CONDITIONS
Signature: .........................................................
Date:......................
CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property
stating the list of items required to be completed for each individual Department before final occupancy
can be granted. Include approximate completion dates for each item.
The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or
buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration
date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-compliance
may result in an enforcement action.
Owner Contractor ^/,
Signature i ... Date: ('..Z2....l S 4 �� P4.42.3/15
Signature :...................... ........................ Date:
This temporary certificate ensu es tha all fire protection and life safety systems have been completed, inspected, successfully tested and
approved for the specific e f the b iiding specified above to provide a reasonable degree of safety to the occupants from fire and
similar emer(
Buildino Official:...../[ ... ........... ............. --Print:.........L...-.................... .... .....................Date:.. 6.L..-.............
DEPARTMENT ACTIN `After det rmi ation, copies to: 1) applicant. 2) permit file
TempOccForm_2013.doc revised 7/7/14